Perthe´s Disease
(Prepared by Dr Isabel Berrocal)
Male 4 y/o patient with a history of pain of 2 months duration and right leg limping . It is evaluated with bone scintigraphy for suspected Perthes disease. See cold area in right femoral head (arrow), on pinhole collimator image.
Idiopathic avascular necrosis of femoral capital epiphysis, occurs most often between the ages of 5 year and 8 year of age. In 90% of cases it is unilateral and the clinical presentation is insidious. Skeletal scintigraphy is frequently used in assesment of young children who present with limping as their only or predominant symptom. It has a high sensitivity in the earliest period of the disease and predates to the radiographic manifestations. The absence of uptake in the femoral head is the main finding. In the differential diagnosis include synovitis and a rare condition known as Meyer dysplasia.References:
Conolly LP, et al. Skeletal scintigraphy in the multimodality assessment of young children with acute skeletal symptoms.Clin Nucl Med. 2003 Sep;28(9):746-54.